Dec 03, 2021  
Course/Program Inventory 
    
Course/Program Inventory

Healthcare Management


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Associate of Applied Science (A.A.S.) in Healthcare Management

Program of Study Summary

College:        Nashville State Community College

Academic Program Inventory (API) Titles:

A.A.S. in Healthcare Management

  • Medical Billing, Coding and Auditing Concentration
  • Healthcare Compliance Concentration
  • Medical Management Concentration

CIP codes:                                                  SOC codes:

API CIP code:     31.51.0701.00                          SOC 1:                      

Actual CIP code: SOC                                            SOC

Concentration CIP code:                                        SOC  

 

Professional Accrediting Body: Accreditation Council for Business Schools & Programs (ACBSP)                                                            

State Agency/Entity Oversight:   None

 

Applicable Certification/License or Industry-recognized Certificates to be awarded:

 

The following certifications are from AAPC (formerly American Academy of Professional Coders). This organization’s focus is consistent with the mission and focus of the HCM program. The program’s focus is “the business” of healthcare and the overall management of the program, which includes management functions such as revenue, compliance, health organization behavior, and practice management. AAPC’s focus is the management of the healthcare process and its corresponding business functions.
 

Below are the certifications and required coursework that must be completed for students in each concentration to sit for these certification exams.

 

 

Certified Professional Medical Auditor (CPMA) (Completion of Medical, Billing, Coding and Auditing Concentration)

  • Medical documentation, fraud, abuse, and penalties for documentation and coding violations based on governmental guidelines
  • Coding Concepts; need CPC and experience coding
  • Scope and Statistical Sampling Methodologies
  • Medical Record Auditing Skills and Abstraction Ability
  • Quality Assurance and Coding Risk Analysis
  • Communication of Results and Findings
  • The Medical Record

 

*Note: Required courses to sit for this certification include all courses in the major field core and the required concentration core courses for Medical Billing, Coding, and Auditing.

 

The Certified Professional Biller (CPB) (Completion of Medical Billing, Coding and Auditing Concentration)

 

  • Understanding of the various types of insurance plans
  • Application of payer policy, Local Coverage Determinations (LCD), and National Coverage Determinations (NCD) for successful claim submissions
  • Knowledge of CPT®, ICD-10-CM, and HCPCS Level II coding guidelines
  • Successful navigation of the varying rules and regulations applying to the healthcare industry, including HIPAA, False Claims Act, Fair Debt Collections Act, and Stark
  • Understanding of the life cycle of a medical billing claim and how to improve the revenue cycle
  • Expertise in effective claim follow-up, patient follow-up, and denial resolution
     

*Note: Required courses to sit for this certification include all courses in the major field core courses and the required concentration core courses for Medical Billing, Coding, and Auditing.

 

Certified Professional Compliance Officer (CPCO) (Completion of Healthcare Compliance Concentration)

  • The OIG Compliance Guidance for Individual and Small Group Physician Practices, Clinical Laboratories, and Third Party Billing Companies
  • Compliance program effectiveness
  • Key healthcare fraud and abuse laws including the False Claims Act, Stark Laws, and Anti-kickback Statute, including the associated penalties
  • How PPACA will affect medical practices
  • Other laws and regulations including HIPAA, EMTALA, and CLIA
  • Handling investigations, including self-disclosure protocols
  • Requirements under Corporate Integrity Agreements (CIAs) and Certificate of Compliance Agreements (CCAs)
  • Current investigative activities (RACs, ZPICs, MFCUs)
  • Various risk areas including items such as gifts/gratuities, conflicts of interest, use of Advance Beneficiary Notices, teaching physicians guidelines, and incident to services

*Note: Required courses to sit for this certification include all courses in the major field core courses and the required concentration core courses for Healthcare Compliance.

 

Certified Physician Practice Manager (CPPM) (Completion of Medical Management Concentration)

  • Understanding of the various types of insurance plans
  • Healthcare business process, workflow, and reform
  • Fraud, abuse, and corporate compliance
  • Quality in health care
  • Medical office accounting, physician reimbursement, and revenue cycle management
  • Human resource management
  • Marketing and business relationships
  • HIPAA and data security
  • Health IT, EMRs, and health information exchange

    *Note: Required courses to sit for this certification include all courses in the major field core courses and the required concentration core courses for Medical Management.

 

Articulation with Tennessee Colleges of Applied Technology (TCAT): None at this time.

 

Concentration Descriptions within the A.A.S. in Healthcare Management

 

Medical Coding Concentration:

This concentration focuses on the fundamentals of healthcare organizations with specialized training in Current Procedural Terminology (CPT) and International Classification of Diseases (ICD). The Medical Billing, Coding and Auditing Concentration focuses on medical terminology, anatomy and physiology, fundamentals of medical science and treatment procedures, data classification and coding, and regulations relating to Medicare and insurance documentation.

 

Healthcare Compliance Concentration:

This concentration prepares students to create and manage a compliance program in a healthcare organization. The Healthcare Compliance Concentration focuses on legal issues unique to healthcare, the responsibilities associated with compliance, and understanding the roles of healthcare employees in reference to compliance. Emphasis is placed on understanding current laws specific to compliance and fraud and abuse.

 

Medical Management Concentration:

This concentration prepares students to manage the specialized business functions in a healthcare organization. The Medical Management Concentration focuses on healthcare organizations, the roles of healthcare workers, information technology, business office operations, financial management, personnel supervision, and regulatory and ethical issues of healthcare.

 

 

Program Description, including Program Outcomes:

The Healthcare Management program prepares students for various entry-level positions within the healthcare setting. The program includes courses that provide the student with business skills as well as ethical, theoretical, and practical issues related to healthcare settings.
 

A.A.S. in Healthcare Management Program Outcomes:

Students will be able to:

  1. Demonstrate an understanding of federal, state, and local laws and regulations affecting medical office technologies
  2. Identify various types of healthcare delivery systems and items unique to each
  3. Demonstrate an understanding of medical reimbursement practices and how to conduct a chart audit for both quality review and billing practices
  4. Apply critical thinking skills to real world strategies in the healthcare industry

 

 

 

 

 

 

 

Curriculum: 60 SCH


The proposed curriculum complies with accreditation standards of the Accreditation Council for Business Schools & Programs (ACBSP).

General Education Requirements: 15-16 SCH


ENGL 1010 ENGLISH COMPOSITION I  3
SPCH 1010 FUNDAMENTALS OF SPEECH COMMUNICATION     3
OR    
SPCH 1112 SPEECH  
APPROVED GENERAL EDUCATION SOCIAL SCIENCE COURSE   3
HUM APPROVED GENERAL EDUCATION HUMANITIES COURSE 3
     
MATH or SCIENCE (depending on concentration)    
MATH 1530 Probability/Statistics     3
OR    
MATH 1630  Finite Mathematics  
OR    
BIOL 2010 Anatomy and Physiology         

4

* COURSES MUST BE CHOSEN FROM THE APPROVED TBR LIST OF COMMON GENERAL EDUCATION CORE COURSES. List can be found at http://tbr.edu/offices/academicaffairs.aspx?id=7879                                                                

Required Concentration Core Requirements


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